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For primary prophylaxis of cardiovascular disease, low-dose Aspirin must be avoided in adults sixty years and above.
A recent study on Aspirin's efficacy to minimize hazard of cardiovascular disease (CVD) events (stroke, myocardial infarction), all-cause mortality, and cardiovascular mortality in people without CVD history was commissioned by the US Preventive Services Task Force (USPSTF) to update its 2016 recommendation. In this systematic review, researchers also looked at the negative effects of Aspirin usage (especially bleeding) and impact of Aspirin usage on colorectal cancer occurrence and mortality in the primary CVD prevention population.
In addition, the USPSTF requested a microsimulation modelling research to determine the overall balance of advantages and disadvantages associated with the use of Aspirin (nonsteroidal anti-inflammatory drugs, NSAIDs) for the primary prevention of colorectal cancer and CVD, stratified by gender, age, and risk level of CVD. Adults forty years of age and older without symptoms of CVD, those who had a history of CVD (including stroke or myocardial infarction), and those who are not at elevated risk for bleeding (such as no history of gastrointestinal ulcers, recent bleeding, other medical situations, or usage of medicines that escalate bleeding risk).
There is moderate certainty that Aspirin usage for primary prevention of CVD events in persons aged forty to fifty-nine who exhibit a 10-year CVD risk of 10% or more is associated with little net profit. Also, there is no net advantage of commencing Aspirin for primary prevention of CVD events in persons sixty years of age or older. The decision to prescribe Aspirin for primary prevention should be made by the patient and their medical care provider following discussion of individual risks and benefits.
The evidence illustrates that there is a minor net benefit from Aspirin usage in this group. Individuals who are ready to take low-dose Aspirin daily and are not at elevated risk for bleeding are potentially likely to avail benefits (Recommended grade: C). For individuals sixty years of age and above, the USPSTF advises against commencing low-dose Aspirin use as the primary method of CVD prevention. (Recommended grade: D).
JAMA
Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement
Karina W Davidson et al.
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